Militaru Anda Gabriela, Lighezan Daniel Florin, Cimpean Anca Maria, Amaricai Elena, Militaru Marius
Department of Internal Medicine I, Medical Semiology I, "Victor Babes" University of Medicine and Pharmacy Timisoara, Municipal Emergency Hospital Timisoara, Eftimie Murgu Square No 2, 300041 Timisoara, Romania.
Center of Advanced Research in Cardiology and Hemostasology, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
Life (Basel). 2025 Apr 27;15(5):704. doi: 10.3390/life15050704.
Subclinical atherosclerosis is a "silent" cardiovascular disease that can be devastating when combined with other illnesses. Its presence may affect therapy responses but can potentially worsen hematological malignancies due to most chemotherapy regimens' cardiovascular adverse effects. Thus, cardiovascular risk factor (CVRF) assessment is required before chemotherapy. Unfortunately, this rarely happens.
we aim to examine the impact of CVRFs on hemodynamic parameters of acute leukemia (AL) patients before chemotherapy.
Overall, 45 AL patients and 26 controls were included. Intima-media thickness (IMT), ankle brachial index (ABI), pulse wave velocity (PWV), and functional cardiac parameters were used. CVRFs were found in 26 AL patients (36.6%), while 19 AL (26.8%) patients lacked CVRFs. CVRFs were also found in 26 controls (36.6%).
Left ventricular ejection fraction (LVEF) significantly decreased for patients with CVRFs (59.26 ± 5.62) compared to those without CVRFs (64.05 ± 7.43, < 0.05). Hypertensive and diabetic patients had a significantly higher left IMT (mm) of 0.92 ± 0.01 compared to those without them (0.76 ± 0.03, < 0.05). Patients with acute myeloid leukemia (AML) with CVRFs had a significantly higher PWV (m/s) of 8.4 ± 0.12 compared to those without CVRFs (6.87 ± 0.66) ( < 0.05).
AL and cardiovascular risk factors interacted before chemotherapy. To decrease cardiotoxicity, AL patients need cardiovascular risk assessment. Subclinical atherosclerosis and echocardiography help chemotherapy patients to choose a treatment regimen, predict long-term outcomes, and predict cardiovascular issues.
亚临床动脉粥样硬化是一种“无声”的心血管疾病，与其他疾病合并时可能具有破坏性。它的存在可能影响治疗反应，但由于大多数化疗方案的心血管不良反应，可能会使血液系统恶性肿瘤恶化。因此，化疗前需要评估心血管危险因素（CVRF）。不幸的是，这种情况很少发生。
我们旨在研究化疗前CVRF对急性白血病（AL）患者血流动力学参数的影响。
共纳入45例AL患者和26例对照。使用了内膜中层厚度（IMT）、踝臂指数（ABI）、脉搏波速度（PWV）和心脏功能参数。26例AL患者（36.6%）存在CVRF，而19例AL患者（26.8%）不存在CVRF。26例对照中也发现了CVRF（36.6%）。
与无CVRF的患者（64.05±7.43）相比，有CVRF的患者左心室射血分数（LVEF）显著降低（59.26±5.62，P<0.05）。高血压和糖尿病患者的左IMT（mm）显著高于无高血压和糖尿病的患者（0.92±0.01对0.76±0.03，P<0.05）。有CVRF的急性髓系白血病（AML）患者的PWV（m/s）显著高于无CVRF的患者（8.4±0.12对6.87±0.66）（P<0.05）。
化疗前AL与心血管危险因素相互作用。为降低心脏毒性，AL患者需要进行心血管风险评估。亚临床动脉粥样硬化和超声心动图有助于化疗患者选择治疗方案、预测长期预后以及预测心血管问题。
